Attention problems in very preterm children from childhood to adulthood: the Bavarian Longitudinal Study

J Child Psychol Psychiatry. 2016 Feb;57(2):132-40. doi: 10.1111/jcpp.12456. Epub 2015 Aug 19.


Background: Very preterm (VP; gestational age <32 weeks) and very low birth weight (VLBW; <1500 grams) is related to attention problems in childhood and adulthood. The stability of these problems into adulthood is not known.

Methods: The Bavarian Longitudinal Study is a prospective cohort study that followed 260 VP/VLBW and 229 term-born individuals from birth to adulthood. Data on attention were collected at 6, 8, and 26 years of age, using parent reports, expert behavior observations, and clinical ADHD diagnoses.

Results: At each assessment, VP/VLBW individuals had significantly more attention problems, shorter attention span, and were more frequently diagnosed with ADHD than term-born comparisons. In both VP/VLBW and term-born individuals, overall, attention span increased and attention problems decreased from childhood to adulthood. Attention problems and attention span were more stable over time for VP/VLBW than term-born individuals. Similarly, ADHD diagnoses showed moderate stability from childhood to adulthood in VP/VLBW, but not in term-born individuals. However, when those with severe disabilities were excluded, differences between VP/VLBW and term-born individuals reduced.

Conclusions: Despite improvement in attention regulation from childhood to adulthood, children born very preterm remained at increased risk for attention problems in adulthood. In contrast, term-born children with clinical attention problems outgrew these by adulthood. As inattentive behavior of VP/VLBW children may be overlooked by teachers, it may be necessary to raise awareness for school intervention programs that reduce attention problems in VP/VLBW children.

Keywords: ADHD; attention; longitudinal studies; low birth weight; prematurity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attention / physiology*
  • Attention Deficit Disorder with Hyperactivity / physiopathology*
  • Child
  • Female
  • Germany
  • Human Development / physiology*
  • Humans
  • Infant, Extremely Premature / physiology*
  • Infant, Very Low Birth Weight / physiology*
  • Longitudinal Studies
  • Male